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Agency Medical Director Credentialing Packet

Agency Medical Director Letter of Agreement (this download includes Agency Medical Director Information Form)

Agency Medical Director Information Form (every agency must submit this form annually by January 31)

Agency Medical Director Verification Form (DOH-4362)

Agency Personnel Roster Form

ALS Provider, Agency Letter of Support Form

Awards Application

Awards Criteria

Credentialing Application

EMS Agency Directory Survey Form

EMS Agency Information Update Form

EMS Agency Quarterly QI Report Form

Epi-Pen Program for EMS Providers

Epi-Pen Program for School and Camps

Hospital Directory Survey Form

Intranasal Naloxone Information

Narcotics Information and Application Forms (Link to most up-to-date forms)

Public Access Defibrillation Program (PAD)

 

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